Early Effect of Bariatric Surgery on Urogenital Function in Morbidly Obese Men

Al-Eid, Maha; Muneer, Asıf; Renshaw, Sara; George, Jason; Jenkinson, Andrew; Adamo, Marco; Elkalaawy, Mohamed; Batterham, Rachel L.; Ralph, David; Hashemi, Majid; Cellek, Selim

doi:10.1016/j.jsxm.2016.12.004

Cited by 29 publications

(35 citation statements)

References 39 publications

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“…The meta-analysis results indicate that bariatric surgery presents conspicuously effective improvements on male's sexual function by comparing IIEF scores, including erectile function, intercourse satisfaction, overall satisfaction, orgasmic function, sexual desire, total erectile function and BSFI scores, including erection, ejaculation, problem assessment, sexual satisfaction. According to Aleid et al [29], the male's sexual function improvements caused by bariatric surgery resulting in increasing all the IIEF domains, which agree with the study performed by Efthymious et al [14] and other researches [24,26,27]. In contrast, studies undertook by Ranasinghe et al [25]and Sarwer et al [11], which also used IIEF to detect male's sexual function, found no effective improvements reaching statistically significance among obese man undergoing bariatric surgery.…”

Section: Discussionsupporting

confidence: 62%

“…Meanwhile, the main finding of the prospective study, performed by Efthymious et al [14], was that the bariatric surgery could lead to a significant improvement in sexual functioning and especially could be find in the first 6 months postoperatively. In a prospective study of bariatric surgery, which used the IIEF score respectively, Aleid et al [29]. similarly find significant improvements in male erectile function.…”

Section: Results Of Each Studymentioning

confidence: 96%

“…The analysis was based on 370 patients from 11 studies with 3 to 24 months follow-up that measured male`s sexual function preoperatively and postoperatively. In these studies [11,14,24,[26][27][28][29][30], the erectile function was found a 5.33-point increase significantly (Fig 2A 95% CI 4.12-6.54, p < 0.001) while there was a 2.57-point increase in the intercourse satisfaction ( Fig 2B 95% CI 1.19-3.94, p = 0.0002), a 0.50-point increase in orgasmic function (Fig 2C 95%CI 0.60-0.94, p = 0.03), a 1.67-point increase in overall satisfaction (Fig 3A 95% CI 0.78-2.56, p = 0.0002), a 1.27-point increase in sexual desire (Fig 3B 95% CI 0.61-1.93, p = 0.0001) in those studies [11,14,24,[26][27][28][29][30]. Meanwhile, total erectile function showed a 7.21-point increase in these studies (Fig 3C 95% CI 4.33-10.10, p < 0.001).…”

Section: Meta-analysismentioning

confidence: 99%

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The relationships between bariatric surgery and sexual function: current evidence based medicine

Liu

Cao

Ren

et al. 2019

Preprint

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Background Controversial remains despite several studies have discussed the role of bariatric surgery for ameliorating male’s sexual function. This study aims to evaluate the efficacy of bariatric surgery in promoting male`s erectile function. Methods We performed a systematic review according to PubMed, EMbase, The Cochrane Library, CNKI and Clinical Trails.gov searching for eligible studies and conducted a meta-analysis to compare the International Index of Erectile Function (IIEF) score or Brief Male Sexual Function Inventory (BSFI) score preoperatively and postoperatively. Results 11 articles were included in this study. The meta-analysis showed bariatric surgery was associated with significantly improvement in the IIEF score (erectile function: MD = 5.33, 95% CI 4.12-6.54; intercourse satisfaction: MD = 2.57, 95% CI 1.19-3.94; orgasmic function: MD = 0.50, 95%CI 0.60-0.94; overall satisfaction: MD = 1.67, 95% CI 0.78-2.56; sexual desire: MD = 1.27, 95% CI 0.61- 1.93; total erectile function: MD = 7.21, 95% CI 4.33-10.10) and the BSFI score (erection: MD =2.53, 95% CI 2.39-2.67; ejaculation: MD = 1.40, 95% CI 1.28-1.51; desire: MD =1.40, 95% CI 1.32-1.49; problem assessment: MD = 2.20, 95% CI 2.06-2.34; sexual satisfaction: MD = 0.70, 95% CI 0.60-0.76). Conclusions To our knowledge, although the mechanism how Bariatric surgery helps improving male`s erectile function is not well interpreted yet, it`s supported by our results that bariatric surgery may be effective in sexual function promoting for obese individuals.

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Section: Discussionsupporting

confidence: 62%

Section: Results Of Each Studymentioning

confidence: 96%

Section: Meta-analysismentioning

confidence: 99%

See 1 more Smart Citation

The relationships between bariatric surgery and sexual function: current evidence based medicine

Liu

Cao

Ren

et al. 2019

Preprint

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“…Грызуны с ожирением, которых кормят пищей с повышенным содержанием жиров, являются наиболее часто применяемой лабораторной моделью для ЭД [9]. Существуют указания на то, что бариатрическая хирургия приводит к уменьшению выраженности ЭД [10,11].…”

Section: научный обзорunclassified

Male health and obesity – diagnostic and therapeutic approach

Гамидов¹,

Shatylko²,

Гасанов³

2019

Obes. metabol.

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Obesity may present as a significant medical problem for any person, regardless of age or gender. In men obesity causes considerable psychological stress, sexual dysfunction, subfertility, hypogonadism and cardiovascular conditions. These problems may form numerous pathological associations between each other, creating a vicious circle. The main factors which influence male fertility and sexual function in obesity and metabolic syndrome are imbalance of sex hormones and systemic inflammation. In many patients symptomatic treatment is necessary for above-mentioned manifestations, but it is always rational to act on their pathophysiology and to recommend to lower the body mass by diet and lifestyle modification. When it proves impossible for the patient to follow such recommendations and when behavioral approach fails, central-acting and peripheral-acting medications may be used, including orlistat, sibutramine and liraglutide. Bariatric surgery should be offered to patients with high body mass index in whom conservative management fails. Without elimination of excess body mass it is difficult to solve problems regarding sexual dysfunction, hypogonadism and subfertility in obese males. All these issues and available modes of pharmacological treatment are described in this review.

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“…A 14-year prospective study identified obesity as a risk factor for erectile dysfunction [ 14 ] and a 12-week HF diet decreased erectile function in rats [ 15 ]. Moreover, weight reduction with bariatric surgery improved erectile dysfunction significantly in obese men [ 16 ]. Recently, Moon et al [ 17 ] reported that daily administration of udenafil (75 mg/d) for 6 months improved erectile dysfunction in a randomized placebo-controlled clinical trial.…”

Section: Introductionmentioning

confidence: 99%

Udenafil, a Phosphodiesterase 5 Inhibitor, Reduces Body Weight in High-Fat-Fed Mice

Ryu

Choi

Park

et al. 2018

World J Mens Health

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PurposeHigh-fat (HF) feeding induces hypothalamic leptin resistance via the activation of toll-like receptor 4 (TLR4). TLR4 deficiency confers resistance to diet-induced obesity. Udenafil, an anti-impotence drug, inhibits TLR4 in airway epithelial cells in vitro. In this study, we evaluated whether udenafil suppressed the hypothalamic expression of TLR4 and reduced body weight.Materials and MethodsThe hypothalamic expression of TLR4, phosphodiesterase 5 (PDE5), nuclear factor-κB (NF-κB), and myeloid differentiation primary response gene 88 (Myd88) was analyzed by real-time polymerase chain reaction after treating mice for 2 days with udenafil (0, 12, 120, or 600 µg/d). Furthermore, the hypothalamic expression of TLR4, pro-opiomelanocortin (POMC), and neuropeptide Y (NPY) was analyzed after 9 days' treatment with udenafil and/or leptin. We also measured body weight and food intake following 9 days of udenafil and/or leptin treatment in control- and HF-fed mice.ResultsUdenafil suppressed hypothalamic TLR4 mRNA expression dose-dependently. The changes were associated with decreased PDE5, NF-κB, and Myd88 expression. Udenafil treatment for 9 days reduced body weight and caloric intake in HF-fed mice. This may have been associated with the suppression of NPY expression that was elevated by HF feeding. POMC expression was not affected by udenafil. However, udenafil did not augment the effects of leptin on the reduction of body weight and caloric intake in HF-fed mice.ConclusionsThese results suggested that udenafil reduced body weight by suppressing hypothalamic TLR4 mRNA expression in HF-fed mice and the combination effect of udenafil and leptin was additive rather than synergistic.

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Early Effect of Bariatric Surgery on Urogenital Function in Morbidly Obese Men

Cited by 29 publications

References 39 publications

The relationships between bariatric surgery and sexual function: current evidence based medicine

The relationships between bariatric surgery and sexual function: current evidence based medicine

Male health and obesity – diagnostic and therapeutic approach

Udenafil, a Phosphodiesterase 5 Inhibitor, Reduces Body Weight in High-Fat-Fed Mice

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